The National Institutes of Health has awarded a $1.39 million grant to the Stempel College of Public Health and Social Work to study how patient-centered HIV care influences patients seeking medical care and how they participate in treatment to suppress the HIV virus.

Mary Jo Trepka

Led by epidemiology professor Mary Jo Trepka, the five-year study will look at how variations in the care provided to low-income HIV-infected patients in the Ryan White program in Miami-Dade County is affecting overall health outcomes. The Ryan White HIV/AIDS Program is a national comprehensive system of care that includes primary medical care and essential support services for people living with HIV who are uninsured or underinsured. The study is a collaboration between FIU, Behavioral Science Research Corporation and Miami-Dade County, which manages the Ryan White Program.

Currently, Miami and Fort Lauderdale lead the country with the highest rates of new HIV diagnoses per capita. While being diagnosed with HIV is no longer the death sentence it once was, the new-infection rate still causes concern. One way to address that concern is to ensure that those infected with HIV are properly cared for and take precautions that suppress the virus and address healthcare needs.

“Viral suppression not only benefits the individual, but it also benefits the community by decreasing the number of people who can transmit HIV infection, and by preventing the transmission of HIV strains that are resistant to antiviral medications,” Trepka said. “In order to guide the development of interventions to optimize HIV care and treatment delivery, this project will identify HIV provider factors that help patients remain in care, take their medications and be virally suppressed.”

Effectively suppressing the HIV virus in a patient virtually eliminates the possibility of that patient transmitting the virus to uninfected persons. Retention in care and viral suppression programs have been particularly challenging for minority populations, leading to racial and ethnic disparities in HIV outcomes, including survival. Among people living with HIV in 2013, the percentage that was virally suppressed was 51.5 percent among African Americans, 58.2 percent among Hispanics, and 65 percent among non-Hispanic whites.

“What is unique about this project is that we are looking at changes in barriers that low-income people face in entering and staying in treatment, as well as how reducing these barriers affects their success in HIV treatment, and how the health care system can support these people in the face of economic and medical adversity. The Ryan White Program serves over half the people in the United States who live with HIV, so our findings can potentially have a very large impact,” Trepka said.

This research is supported by the National Institute on Minority Health and Health Disparities of the National Institutes of Health.